摘要
目的探讨夫妇ABO血型不合O型血孕妇免疫球蛋白(Ig)G抗A/B效价与新生儿溶血病(HDN)的相关性。方法选择2015年2月至2017年8月,于山东省血液中心血型参比研究室进行夫妇ABO血型不合产前血型抗体检查的104例O型Rh阳性血型孕妇为研究对象。孕妇年龄为(26.5±6.8)岁。根据孕妇的孕次,将其分为3组:首次妊娠组(n=31),2次妊娠组(n=35),≥3次妊娠组(n=38)。采用微柱凝胶法检测孕妇及其丈夫的ABO血型、孕妇的Rh血型及血清IgG抗A/B效价。对新生儿脐静脉血标本进行HDN 3项试验,包括红细胞直接抗人球蛋白试验、血清游离抗体试验和红细胞抗体释放试验。根据以上检测结果,分别计算孕妇血清IgG抗A/B阳性率和新生儿ABO-HDN发生率,并且分析孕妇孕次、血清IgG抗A/B效价、新生儿ABO-HDN发生率的相关性。采用方差分析比较3组孕妇的年龄、孕龄等的总体差异。采用χ2检验对3组孕妇血清IgG抗A/B阳性率,母体不同血清IgG抗A/B阳性率的新生儿ABO-HDN发生率进行比较。以上资料进一步两两比较,采用Bonferroni法调整检验水准。采用Spearman轶相关分析孕妇的孕次、血清IgG抗A/B效价、新生儿ABO-HDN发生率3者的相关性。本研究遵循的程序符合山东省血液中心医学伦理委员会制定的标准,经过该伦理委员会批准(批准文号:鲁血伦审字[2019]5号),并与所有受试者及其监护人签署临床研究知情同意书。结果①本研究104例孕妇的ABO血型均为O型,Rh血型均为Rh阳性。其丈夫的ABO血型包括,A型41例、B型48例和AB型15例。新生儿的ABO血型包括,A型45例,B型50例,O型9例。②本研究104例孕妇的血清中,IgG抗A/B总阳性率为65.4%(68/104)。初次、2次、≥3次妊娠组孕妇血清IgG抗A/B阳性率分别为45.2%(14/31)、65.7%(23/35)、81.6%(31/38),3组比较,总体差异有统计学意义(χ2=10.007,P=0.008)。其中,≥3次妊娠组孕妇血清IgG抗A/B阳性率最高,与首次妊娠组�
Objective To investigate the correlation between immunoglobulin (Ig) G anti-A/B titer and neonatal hemolytic disease (HDN) in pregnant women with O blood group from ABO blood group incompatibility couples. Methods From February 2015 to August 2017, a total of 104 pregnant women with O-type and Rh-positive blood group who underwent prenatal blood group antibody test because of couples with ABO blood group incompatibility in the Blood Type Reference Laboratory of Blood Center Shandong Province were selected as subjects. The average age of pregnant women were (26.5±6.8) years. According to gravidity of these pregnant women, they were divided into 3 groups : first pregnancy group (n=31), twice pregnancy group (n=35) and≥3 times pregnancy group (n=38). Micro-column method were performed to detect the ABO blood group of the couples, the Rh blood group and titer of serum IgG anti-A/B of pregnant women. The umbilical vein blood samples of newborns were tested by direct anti-globulin test, free antibody test and antibody elution test. The positive rate of serum IgG anti-A/B in pregnant women, the incidence of ABO-HDN in newborns, as well as the correlation among gravidity, serum IgG anti-A/B titer and incidence of ABO-HDN were calculated, respectively. The age and gestational age of pregnant women among 3 groups were compared by variance analysis. The positive rate of serum IgG anti-A/B of pregnant women among 3 groups, and the incidence of ABO-HDN of newborns among different maternal serum IgG anti-A/B titer, were compared by chi-square test, respectively. And further pairwise comparison of above data used Bonferroni method to adjust the significance level. The correlation among the gravidity maternal, serum IgG anti-A/B titer, and neonatal ABO-HDN incidence were analyzed with Spearman rank correlation analysis. The procedures followed in this study were in accordance with the standards established by the Medical Ethics Committee of Blood Center Shandong Province, and this study was approved by the committee. All the
作者
李京
沈云青
徐群
Li Jing;Shen Yunqing;Xu Qun(Blood Center Shandong Province, Jinan 250014, Shandong Province, China)
出处
《国际输血及血液学杂志》
CAS
2019年第5期420-424,共5页
International Journal of Blood Transfusion and Hematology
关键词
血型不合
ABO血型系统
孕妇
免疫球蛋白G
幼红细胞增多症
胎儿
Blood group incompatibility
ABO blood-group system
Pregnant women
Immunoglobulin G
Erythroblastosis, fetal
